Homestead_Wade (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbey Moore Closing Agent
Company
Address(number and street,city,state,country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conyJJJjI)nclTrlt
Frederick A. Dallmier Jama R. Dallmier
Address(number and street) Address(number and street)
AUG 3 0 2022C�
5970 N 400th St 5970 N 400th St � /�
City,state,and ZIP Code City,state,and ZIP Code � 1 & 1it .:na
Oblong, IL 62449 Oblong, IL 62449 GIBSON COUNTYAMIITOI
Country Country
USA USA
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
TeofSeh2
d Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Dat signed mm/dd/yyyy)
Frederick A.Dallmier 08/26/2022 Jama R. Dallmier 08/26/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Breann Nicole Wade Noah Michael Wade
Address(number and street) Address(number and street)
905 East Kentucky Street 905 East Kentucky Street
City,state,and ZIP Code ti City,state,and ZIP Code
Princeton, IN 47670 i Princeton, IN 47670
Country Country
USA I USA
1.Will this property be the buyer's primary El El 3. Homestead
ISI ❑ residence? ❑ m 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 5.Wind Power Device
❑ for this residence? If yes, provide address: ❑ m 6.Hydroelectric Power Device
Address(number and street) 0 m 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 6�1 2—(1^ (0 I--00/-1 • 2 3 b — 02 •
-
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
as required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of
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